An Evaluation of Vaccination Practices of Nursing Home Residents and Staff Project Summary Objectives: There are three major objectives of this evaluation;1) to gain an understanding of the vaccination practices of nursing home residents;2) to learn about nursing home staffs'personal attitudes and beliefs surrounding vaccination and whether their practices have the potential to influence their patients;and 3) to evaluate the validity of influenza vaccination status and race reported on nursing home residents'assessments. Specific Aims: The specific aims of this study are to determine the processes for offering, delivering, and documenting influenza vaccination for residents and staff at nursing homes, and identify barriers that may exist toward vaccinating residents and staff against seasonal influenza. An additional aim is to determine staffs'knowledge, attitudes, and practices of influenza vaccination delivery to residents and for themselves. Also, the study seeks an understanding of the ways in which both the race of the nursing home patient and race of the staff may influence the decision of patients to receive influenza vaccine. A final aim of the study is to assess the validity of reported influenza vaccination status and race on the resident assessment instrument (RAI) by comparing RAI data to patient vaccination and medical records. Research Design and Methods: Using a case study approach, the study will incorporate both qualitative and quantitative methods to explore the vaccination practices of nursing home residents and staff in three states, Florida, Georgia, and Wisconsin. Interviews with nursing home administrators and staff in charge of immunization programs will be conducted to learn about the decision-making processes and procedures for offering, delivering, and reporting resident vaccination status, including race. These interviews will also explore nursing homes'policy regarding staff vaccination. Focus groups with a small sample of nursing home staff will also be held to learn about their attitudes, beliefs, and practices regarding vaccination and to help develop a survey of vaccination practices of nursing home staff. Finally, quantitative analyses will be conducted using resident assessments and medical charts to validate vaccination status and race. PUBLIC HEALTH RELEVANCE: Project Narrative: The proposed research study will assess how nursing homes offer, deliver, and document the vaccination status and race of their residents. The vaccination attitudes and beliefs of nursing home staff in these states will also be studied to learn if their vaccination practices have the potential to influence the nursing home residents they serve. Using mixed methods (qualitative and quantitative), the data collected from this study have the potential to inform public policy, clinical practice, training of nursing and allied health providers, and guide the development and implementation of interventions designed to improve nursing home resident and staff vaccination.